학술논문
CLINICAL RELEVANCE OF EXTENDED PLATELET INDICES IN THE DIAGNOSIS OF IMMUNE THROMBOCYTOPENIA/KLINICKA VAzNOST DODATNIH TROMBOCITNIH POKAZATELJA U DIJAGNOSTICI IMUNE TROMBOCITOPENIJE
Original Scientific Paper
Original Scientific Paper
Document Type
Report
Source
Acta Clinica Croatica. December 2021, Vol. 60 Issue 4, p665, 10 p.
Subject
Language
English
ISSN
0353-9466
Abstract
Introduction Platelets are non-nucleated, membrane bound, disk-like structures. They activate coagulation factors by activating their membrane phospholipids in blood clotting due to impaired blood vessel flow (2). Trombocytopenia or decreased [...]
Immune thrombocytopenia (ITP) is an autoimmune disorder. Besides platelet count, immature platelet fraction (IPF) can be used as a tool to predict megakaryocytic activity in ITP patients. The aim of the study was to evaluate the utility of extended platelet indices in ITP diagnosis and their association with disease persistence and severity. This case-control study (1:1), conducted from January 2015 to December 2017, included 111 ITP patients and 111 healthy controls. ITP patients were grouped as newly diagnosed ITP, persistent ITP, chronic ITP, and refractory ITP patients. Peripheral blood was collected and complete blood profile parameters were recorded using Sysmex XN 1000. Significant (p[less than or equal to]0.05) difference between the groups of ITP patients and healthy control subjects was determined by Fisher exact test, while Pearson correlation was used to evaluate platelet count correlation with IPF using SPSS ver. 23. Low hemoglobin and platelet counts with high total leukocyte count and IPF were detected in ITP patients as compared to healthy subjects (p[less than or equal to]0.001). Among all groups of ITP patients, very low platelet count (6.9[+ or -]6.02.x[10.sup.9]/L) with highest mean IPF (27.1[+ or -]19.2%) was observed in newly diagnosed ITP group. Other platelet parameters including mean platelet volume (MPV), plateletcrit, platelet large cell ratio (P-LCR) and platelet distribution width values were also altered in patient groups. Pearson correlation revealed negative relationship between platelet count and IPF in all patient groups. With the advent of new, sophisticated hematologic analyzers, the IPF and other platelet parameters provide simple, reliable and easier tools for predicting platelet disorders such as ITP, and to some extent the disease severity. Besides IPF, the MPV and P-LCR seemed to predict disease severity, treatment responsiveness, and duration of the disease to some extent. Key words: Immune thrombocytopenia purpura; Chronic immune thrombocytopenia; Mean platelet volume; Immature platelet f raction Imuna trombocitopenija (ITP) je autoimuna bolest. Uz broj trombocita, frakcija nezrelih trombocita (immature platelet fraction, IPF) moze se rabiti za predvidanje megakariocitne aktivnosti kod bolesnika s ITP-om. Cilj ovoga istrazivanja bio je procijeniti primjenu dodatnih trombocitnih indeksa u dijagnostici ITP-a te njihovu povezanost s ustrajnoscu i tezinom bolesti. Ovo ispitivanje slucajeva s kontrolnom skupinom (1:1) provedeno je od sijecnja 2015. do prosinca 2017. godine, a ukljucilo je 111 bolesnika s ITP-om i 111 zdravih kontrolnih ispitanika. Bolesnici s ITP-om podijeljeni su u skupine s novo dijagnosticiranim, ustrajnim, kroninim i refraktornim ITP-om. Prikupljeni su uzorci periferne krvi i parametri kompletnog krvnog profla zabiljezeni na ure c aju Sysmex XN 1000. Znacajne razlike (p[less than or equal to]0,05) izmedu skupina bolesnika s ITP-om i zdravih kontrolnih osoba utvrdene su Fisherovim egzaktnim testom, dok je Pearsonovom korelacijom procijenjena korela cija broja trombocita s IPF pomocu SPSS ver. 23. Nizak hemoglobin i nizak broj trombocita uz visok ukupan broj leukocita i visok IPF zabiljezeni su u bolesnika s ITP-om u usporedbi sa zdravim osobama (p[less than or equal to]0,001). Medu svim skupinama bolesnika s ITP-om, vrlo nizak broj trombocita (6,9[+ or -]6,02x[10.sup.9]/L) uz najvisi srednji IPF (27,1[+ or -]19,2%) utvrden je u skupini bolesnika s novo dijagnosticiranim ITP-om. Ostali trombocitni parametri ukljucujuci srednji volumen trombocita (mean platelet volume, MPV), trombokrit, omjer velikih trombocita (platelet-large cell ratio, P-LCR) i sirina distribucije volumena trombocita bili su takoder promijenjeni u skupinama bolesnika s ITP-om. Pearsonova korelacija pokazala je negativan odnos izmedu broja trombocita i IPF u svim skupinama bolesnika. Uz nove, naprednije hematoloske analizatore trombocitni parametri poput IPF i drugi nude jednostavan, pouzdan i laksi nacin za predvidanje trombocitnih bolesti kao sto je ITP, a do neke mjere i tezine bolesti. Uz IPF, cini se da MPV i P-LCR imaju utjecaj na tezinu bolesti, odgovor na terapiju i trajanje bolesti. Kljucne rijeci: Imuna trombocitopenija purpura; Kronicna imuna trombocitopenija; Srednji volumen trombocita; Frakcija nezrelih trombocita
Immune thrombocytopenia (ITP) is an autoimmune disorder. Besides platelet count, immature platelet fraction (IPF) can be used as a tool to predict megakaryocytic activity in ITP patients. The aim of the study was to evaluate the utility of extended platelet indices in ITP diagnosis and their association with disease persistence and severity. This case-control study (1:1), conducted from January 2015 to December 2017, included 111 ITP patients and 111 healthy controls. ITP patients were grouped as newly diagnosed ITP, persistent ITP, chronic ITP, and refractory ITP patients. Peripheral blood was collected and complete blood profile parameters were recorded using Sysmex XN 1000. Significant (p[less than or equal to]0.05) difference between the groups of ITP patients and healthy control subjects was determined by Fisher exact test, while Pearson correlation was used to evaluate platelet count correlation with IPF using SPSS ver. 23. Low hemoglobin and platelet counts with high total leukocyte count and IPF were detected in ITP patients as compared to healthy subjects (p[less than or equal to]0.001). Among all groups of ITP patients, very low platelet count (6.9[+ or -]6.02.x[10.sup.9]/L) with highest mean IPF (27.1[+ or -]19.2%) was observed in newly diagnosed ITP group. Other platelet parameters including mean platelet volume (MPV), plateletcrit, platelet large cell ratio (P-LCR) and platelet distribution width values were also altered in patient groups. Pearson correlation revealed negative relationship between platelet count and IPF in all patient groups. With the advent of new, sophisticated hematologic analyzers, the IPF and other platelet parameters provide simple, reliable and easier tools for predicting platelet disorders such as ITP, and to some extent the disease severity. Besides IPF, the MPV and P-LCR seemed to predict disease severity, treatment responsiveness, and duration of the disease to some extent. Key words: Immune thrombocytopenia purpura; Chronic immune thrombocytopenia; Mean platelet volume; Immature platelet f raction Imuna trombocitopenija (ITP) je autoimuna bolest. Uz broj trombocita, frakcija nezrelih trombocita (immature platelet fraction, IPF) moze se rabiti za predvidanje megakariocitne aktivnosti kod bolesnika s ITP-om. Cilj ovoga istrazivanja bio je procijeniti primjenu dodatnih trombocitnih indeksa u dijagnostici ITP-a te njihovu povezanost s ustrajnoscu i tezinom bolesti. Ovo ispitivanje slucajeva s kontrolnom skupinom (1:1) provedeno je od sijecnja 2015. do prosinca 2017. godine, a ukljucilo je 111 bolesnika s ITP-om i 111 zdravih kontrolnih ispitanika. Bolesnici s ITP-om podijeljeni su u skupine s novo dijagnosticiranim, ustrajnim, kroninim i refraktornim ITP-om. Prikupljeni su uzorci periferne krvi i parametri kompletnog krvnog profla zabiljezeni na ure c aju Sysmex XN 1000. Znacajne razlike (p[less than or equal to]0,05) izmedu skupina bolesnika s ITP-om i zdravih kontrolnih osoba utvrdene su Fisherovim egzaktnim testom, dok je Pearsonovom korelacijom procijenjena korela cija broja trombocita s IPF pomocu SPSS ver. 23. Nizak hemoglobin i nizak broj trombocita uz visok ukupan broj leukocita i visok IPF zabiljezeni su u bolesnika s ITP-om u usporedbi sa zdravim osobama (p[less than or equal to]0,001). Medu svim skupinama bolesnika s ITP-om, vrlo nizak broj trombocita (6,9[+ or -]6,02x[10.sup.9]/L) uz najvisi srednji IPF (27,1[+ or -]19,2%) utvrden je u skupini bolesnika s novo dijagnosticiranim ITP-om. Ostali trombocitni parametri ukljucujuci srednji volumen trombocita (mean platelet volume, MPV), trombokrit, omjer velikih trombocita (platelet-large cell ratio, P-LCR) i sirina distribucije volumena trombocita bili su takoder promijenjeni u skupinama bolesnika s ITP-om. Pearsonova korelacija pokazala je negativan odnos izmedu broja trombocita i IPF u svim skupinama bolesnika. Uz nove, naprednije hematoloske analizatore trombocitni parametri poput IPF i drugi nude jednostavan, pouzdan i laksi nacin za predvidanje trombocitnih bolesti kao sto je ITP, a do neke mjere i tezine bolesti. Uz IPF, cini se da MPV i P-LCR imaju utjecaj na tezinu bolesti, odgovor na terapiju i trajanje bolesti. Kljucne rijeci: Imuna trombocitopenija purpura; Kronicna imuna trombocitopenija; Srednji volumen trombocita; Frakcija nezrelih trombocita